Geographical distributions of physicians in Japan and US: Impact of healthcare system on physician dispersal pattern
Geographical distributions of physicians in Japan and US: Impact of healthcare system on physician dispersal pattern
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DOI：
10.1016/j.healthpol.2010.02.012
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发表时间：
2010-08-01
期刊：
影响因子：
3.3
通讯作者：
Kajii, Eiji
中科院分区：
文献类型：
--
作者：
Matsumoto, Masatoshi;Inoue, Kazuo;Kajii, Eiji
目的：本研究考察了日本和美国医生数量总体增加对医生地理分布的影响。方法：参照社区人口和社区收入对日本各市、美国各县医师分配公平性进行评价。结果：1980年至2005年间，日本和美国每单位人口的医生数量分别增长了55%和47%。在日本和美国，相对于人口的基尼系数值相近，而且在过去25年里，这两个国家的基尼系数几乎没有变化。美国相对于收入的基尼系数低于日本，而且美国的基尼系数自1980年以来一直在下降。美国的医生与人口比例与社区人均收入之间的相关性强于日本，并且在研究期间日益增强。结论：尽管医生数量不断增长，但两国的医生并没有根据人口分布而扩散。相反，美国的医生似乎是根据收入分配而分散的。为了扭转医生的持续分配不均，这两个国家都需要政治干预。2010爱思唯尔爱尔兰有限公司版权所有。
Objectives: This study examined the effect of increased physician numbers overall on the geographic distribution of the physicians in Japan and the US.Methods: Equity of physician distribution with reference to community population and community income was evaluated in all municipalities in Japan, and all counties in the US.Results: Between 1980 and 2005, Japan and the US experienced a 55% and 47% increase in the number of physicians per unit population, respectively. The Gini coefficients against population were at similar values between Japan and the US, and have been almost unchanged in the past 25 years in both countries. The Gini coefficient against income in the US was lower than the coefficient in Japan, and the US value has decreased since 1980. Correlation between physician-to-population ratio and per capita income among the communities was stronger in the US than in Japan and has increasingly been strengthened during the period examined.Conclusions: In spite of constant growth of physician numbers, physicians do not diffuse according to population distribution in both countries. Rather, US physicians seem to diffuse according to income distribution. In order to reverse the continuing maldistribution of physicians, political intervention is required in both countries. (c) 2010 Elsevier Ireland Ltd. All rights reserved.